A nurse is teaching a newly licensed nurse about didanosine therapy.
Which of the following client conditions should the nurse identify as an indication for treatment with didanosine?

Choice A rationale

Jaundice is a serious indicator of hepatotoxicity, a known and potentially severe adverse effect of rifampin. It signifies liver dysfunction and requires immediate medical attention. Therefore, stating that jaundice is harmless demonstrates a critical misunderstanding of the medication's potential risks and the need for prompt reporting to the healthcare provider.

Choice B rationale

Rifampin is known to cause discoloration of body fluids, including urine, sweat, tears, and saliva, due to its reddish-orange pigment. This discoloration can permanently stain soft contact lenses. Therefore, a client's statement about not wearing soft contact lenses indicates an understanding of this specific and important adverse effect.

Choice C rationale

Rifampin absorption is reduced when taken with food. To maximize its bioavailability and effectiveness, rifampin should be taken on an empty stomach, typically one hour before or two hours after a meal. Taking it when the stomach is full would decrease its therapeutic efficacy, indicating a misunderstanding of the teaching.

Choice D rationale

Rifampin is metabolized by the liver, and alcohol consumption also places a significant metabolic burden on the liver. Concurrent use of rifampin and alcohol significantly increases the risk of hepatotoxicity, which can lead to severe liver damage. Therefore, drinking alcohol while on rifampin is strongly contraindicated and shows a lack of understanding. .

Choice A rationale

Somatropin is a synthetic growth hormone used to treat growth hormone deficiency. The primary therapeutic effect of this medication is to promote linear growth in children. Therefore, monitoring the child's height monthly is a direct and quantifiable measure to evaluate the effectiveness of somatropin therapy and ensure that the child is achieving the expected growth velocity.

Choice B rationale

While thyroid function can influence growth, and growth hormone deficiency can sometimes coexist with or impact thyroid axis, evaluating the therapeutic effect of somatropin directly involves assessing growth. Monitoring thyroid function is important for overall endocrine health but is not the primary measure for the therapeutic effect of somatropin itself, assuming thyroid function is within normal limits (e.g., TSH 0.4-4.0 mIU/L, free T4 0.8-1.8 ng/dL).

Choice C rationale

Checking the child's sodium level regularly is not a direct measure of the therapeutic effect of somatropin. Growth hormone can influence fluid balance, but sodium levels (normal range 135-145 mEq/L) are primarily monitored for hydration status or potential adverse effects like fluid retention, not as an indicator of growth hormone's efficacy in promoting growth.

Choice D rationale

Measuring the child's abdominal girth is a measure of abdominal circumference, primarily used to assess abdominal distention, fluid accumulation, or changes in visceral fat. It is not a relevant parameter for evaluating the therapeutic effect of somatropin, which is specifically aimed at stimulating linear bone growth and overall somatic growth.